Psychotic Disorder (Not Schizophrenia) - Delusional Disorder

6 important questions on Psychotic Disorder (Not Schizophrenia) - Delusional Disorder

Common Delusions in Delusional Disorder

Persecutory (most common): Belief of being harmed or conspired against
. • Jealous: Unfounded belief in a partner’s infidelity.
• Grandiose: Exaggerated beliefs in personal abilities or importance.
• Erotomanic: Belief that someone of higher status is in love with the individual
. • Somatic: Concerns about bodily functions or sensations.
• Mixed: Multiple themes without a predominant type.

Functioning in Delusional Disorder

Functioning is not markedly impaired, and behavior is not obviously bizarre or odd.

Investigation for Delusional Disorder

Eliminate medical cause of delusion
• CT brain
• Metabolic screen (FBS/FSL)
• Biohazard & infectious screen
• Urine for drug
• Endocrine workup
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Pharmacological approach to Delusional Disorder

Antipsychotic – Despite research shows that treating delusional disorder with first generation anti psychotic is slightly more superior than second generation anti psychotic, SGA is more preferred because of it’s better toleratbility profile compared to the FGA . Example of SGA best to be used : Risperidone


Anti Depressant – Best to treat somatic form of delusion such as infestation by anti depressant. It also may have added benefit wuth comorbid anxiety or depressive symptoms as well

Non Pharmacological approach to Delusional Disorder

CBT
Targets reasoning biases, interpersonal sensitivity, worry, and insomnia.
•Shows promise in reducing persecutory delusions but lacks large-scale RCT evidence.

Evidence based practice in Delusional Disorder

Studies have shown effective after getting suitable treatment for at least 3 months. Can consider LAI if anticipating poor compliance to medications

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